Transitions of Care and Disposition

  • Sarah TurpinEmail author
  • Sarah Vince


For every care transition (intra- or extra hospital), the practitioner will be able to formulate the following information:
  • Physiological parameters with the individualised clinical interpretation

  • Clinical narrative including communication needs and key informants

  • Medication and any changes

  • Thoughts about discharge planning and the home environment

  • Escalation status including advance care plans

To assess and document suitability for discharge considering the ED diagnosis, including cognitive function, the ability in ambulatory patients to ambulate safely, availability of appropriate nutrition/social support and the availability of access to appropriate follow-up therapies, discharge planning should include an assessment of whether the patient is able to give an accurate history, participate in determining the plan of care and understand discharge instructions.

Provide skilled nursing homes and primary care providers with an ED visit summary and plan of care, including follow-up when appropriate.


Recommended Reading

  1. 1.
    Campbell SG, Croskerry P, Bond WF (2007) Profiles in patient safety: a “perfect storm” in the emergency department. Acad Emerg Med Off J Soc Acad Emerg Med 14(8):743–749Google Scholar
  2. 2.
    Kessler C, Shakeel F, Hern HG, Jones JS, Comes J, Kulstad C et al (2013) An algorithm for transition of care in the emergency department. Acad Emerg Med Off J Soc Acad Emerg Med 20(6):605–610CrossRefGoogle Scholar
  3. 3.
    Handing over to paramedics and further medical care [Internet]. National Institute of First Aid Trainers. 2014 [cited 2016 Mar 3]. Available from:
  4. 4.
    Gillespie SM, Gleason LJ, Karuza J, Shah MN (2010) Healthcare providers’ opinions on communication between nursing homes and emergency departments. J Am Med Dir Assoc 11(3):204–210CrossRefGoogle Scholar
  5. 5.
    Hot Topics in Healthcare: Transitions of care: the need for a more effective approach to continuing patient care [Internet]. The Joint Commision; 2012 [cited 2016 Feb 5]. Available from:
  6. 6.
    Terrell KM, Miller DK (2011) Strategies to improve care transitions between nursing homes and emergency departments. J Am Med Dir Assoc 12(8):602–605CrossRefGoogle Scholar
  7. 7.
    Salvi F, Morichi V, Grilli A, Giorgi R, De Tommaso G, Dessì-Fulgheri P (2007) The elderly in the emergency department: a critical review of problems and solutions. Intern Emerg Med 2(4):292–301CrossRefGoogle Scholar
  8. 8.
    Kessler C, Williams MC, Moustoukas JN, Pappas C (2013) Transitions of care for the geriatric patient in the emergency department. Clin Geriatr Med 29(1):49–69CrossRefGoogle Scholar
  9. 9.
    ACEP Transitions of Care Task Force. Transitions of Care Task Force Report [Internet]. American College of Emergency Physicians; 2012 [cited 2016 Feb 5]. Available from:

Copyright information

© Springer International Publishing Switzerland 2018

Authors and Affiliations

  1. 1.University Hospitals of Leicester NHS Foundation TrustLeicesterUK
  2. 2.Northampton General Hospital NHS TrustNorthamptonUK

Personalised recommendations